Substance misuse in later life: challenges for primary care: a review of policy and evidence

Rahul Rao; Ilana Crome; Peter Crome; Steve Iliffe

doi:10.1017/S1463423618000440

Substance misuse in later life: challenges for primary care: a review of policy and evidence

Prim Health Care Res Dev. 2019 Jun 20:20:e117. doi: 10.1017/S1463423618000440.

Authors

Rahul Rao^{1

2}, Ilana Crome^{3

4

5

6}, Peter Crome⁷, Steve Iliffe⁸

Affiliations

¹ Consultant Old Age Psychiatrist, South London and Maudsley NHS Foundation Trust, London, UK.
² Visiting Researcher, Institute of Psychiatry, London, UK.
³ Emeritus Professor, Keele University.
⁴ Honorary Professor, Queen Mary University, London, UK.
⁵ Visiting Professor, St George's University, London, UK.
⁶ Senior Research Fellow, Imperial College London, London, UK.
⁷ Emeritus Professor, Department of Primary care and Population Health, University College London, London, UK.
⁸ Emeritus Professor of Primary for Older People, University College London, London, UK.

Abstract

Background: Substance misuse in older people represents a growing clinical and public health problem within primary care.

Aim: The aim of article is to explore policy and research evidence for informing best practice in the assessment, treatment effectiveness, treatment implementation and approaches to recovery for older people with substance misuse in primary care.

Methods: Relevant search terms were used to examine the databases MEDLINE, EMBASE, CINAHL and PsychINFO up to January 2016.

Results: An age-sensitive approach is required to overcome barriers to assessment. Training is essential for developing relevant knowledge, skills and attitudes. Clinical audit be used to develop care pathways, particularly for older people with dual diagnosis. There is also a need to develop closer links between primary care and the secondary care specialties, as well as added value in working with carers and voluntary agencies.

Discussion: Further research is needed to inform more effective approaches to treatment. Adequate funding for workforce development and quality improvement in service development are also essential to improve health outcomes and quality of life in older people with substance misuse.

Keywords: addictions; geriatrics; older people; primary care.

Publication types

Review

MeSH terms

Aged
Aged, 80 and over
Evidence-Based Practice / standards*
Female
Geriatrics / standards*
Humans
Male
Practice Guidelines as Topic*
Primary Health Care / standards*
Substance-Related Disorders / psychology*
Substance-Related Disorders / therapy*